Tonsillotome



April zslflsis.

J. SHEKTER TONSILLOTOME Filed DeE'. 2. 1922 nfra/mars Patented Apr. 28, 1.925.

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ABRAHAM J- SHEKTER, O1? HUNTINGTON, NEW YORK.

TONSILLO'IOME.

Application filed December 2, 1322. Serial No. 604,475.

To all whom it may concern:

Be it known that I, ABRAHAM J. Srrnn'rnn, a citizen of the United States, and a resident of Huntington, county of Nassau, State of New York, have invented certain new and useful Improvements in Tonsillotomes, of which the following is a specification. I

My invention relates to tonsillotomes and has for its object to'provide an instrument of this character which is reliable and efficient in operation with a minimum of effort on the part of the operator and which is capable of being controlled in a manner comfortable to the physician and with a minimum of manual effort. Other more specific objects will appear from the de scription hereinafter and the features of novelty will be pointed out in the appended claims.

Reference is to be had to the accompanying drawings which illustrate an example of the invention without defining its limits and in which Fig. 1 is a side elevation with parts in section; Fig. 2 is a plan view; Fig. 3 is a fragmentary section showing the parts in a different position; Fig. 1 is a cross'section on the line 4-t of Fig. 3 and 5 is a detail view of toothed pawl which forms part of the instrument.

The instrument comprises a main member which is provided with a. bore 11 and with a lengthwise extending slot 12, said member 10 being further formed with a smooth guide surface 13. At one end the main member 10 is constructed with a head 14 from which a tubular member 15 extends forwardly and in registry with a channel 16 extending through the head 14; at its free end the tubular member 15 terminates .in a fenestra 17 which is interiorly grooved as indicated at 18 for the purpose to be set forth more fullyhereinafter. IA snarewire 19 extends through the tubular member 15 and through the channel 10 of the head 1 and is connected with a slide 20 which is slidable lengthwise of the main member 10 upon the smooth guiding surface thereof; at its forward end the snare-wire 19 is arranged to form a loop 21 which is expanded to its fullest extent by the action of the groove 18 0f the fenestra 17 when the slide 20 is moved in one direction and is gradually reduced in size by being withdrawn into the tubular member 15 when said slide 20 is moved in the opposite, direction. In the preferred arrangement the snare-wire 19 is attached to a plug 22 which, in turn, is removably mounted in the slide 20 and secured in connection therewith, for instance, by means of a set screw 23.' A linger-piece 2 1 is carried by and projects downwardly from one side of the slide 20 and serves as a means whereby said slide 20 may beactuated rearwar-dly or away from the fenestra 17 A trigger 25 is pivotally connected at 25 with the slide 20 and is located to the rear of the finger-piece 24: as shown in Figs. 1 and 8, the said trigger extending below the fingerpiece as also illustrated in said figures; a pawl 26 forms part of oris secured to a spring member 27 which is attached at28 to the slide 20; the pawl 26 is provided on its one face with teeth 29 so arranged as to mesh with the screwthreads of an adjusting screw 30 which is rotatably-mounted in the main member 10 and is held therein against lengthwise movement by means of a nut 31 screwed upon the screwthreaded neck 32 of said member 10 as shown in Fig. 1. Any suitable means such as a handle 33 may be provided for rotatably manipulating the screw 30 for the purpose to be more fully described hereinafter.

The pawl 26 projects through the forked end 25 of the trigger 25 and is provided with a'cam surface 26 against which said trigger 25 exerts a pressure to force the pawl 26 into engagement with the screw 30 when said trigger is shifted from the position shown in Fig. 1 to the-position shown in Fig. 3; the purpose of this arrangement will be more fully set forth hereinafter. For convenience of operation a thumb piece 34 is provided upon the slide 20 to enable the same to be shifted forwardly upon the guide surface 13 to return the parts to their initial positions. The instrument further includes a hand-grip 35 in the form of a pistol grip and of a size and shape to co1nfortably'fit the hand of the user of the instrument. In the preferred form this grip 35 is detachably mounted upon the main member 10 and is lined in position thereon, for instance, by means of a set screw 36. In any case the grip 35 extends from the main member 10 in a direction at right angles to the plane of the fenestra 17 and is located in such a relation to the slide 20 and its finger-piece 2d and trigger 25 as to permit the latter to be: comfortably and easily reached and manipulated by two fingers of the same hand in which the grip 35 is grasped. As shown in Fig. t the finger-piece 24 is located somewhat to one side and out of registry with the trigger 25; with this arrangement the positions occupied by the finger located in the finger-piece 24 and the finger by which the trigger 25 is operated, are positively individualized so that interference of these fingers with each other in the operation of the instrument and the possibility of unintentionally manipnlating said slide 20 in an incorrect manner is reduced to a minimum. A trip 37 is located upon that portion of the grip 35 which. is fixed upon the member 10 and serves to automatically trip the trigger in a manner to be more fully described hereinafter.

In utilizing the instrument for its intended purpose the slide 20 is shifted forwardly upon the surface 13 as far as it will go, this being possible because the parts occupy the position shown in Fig. 1. In the described adjustment of the slide 20 the loop 21 of the snare-wire 19 lies within the groove 18 of the fenestra 17 and is entirely out of the way. The fenestra is then placed over the tonsil in the customary manner after which a pull is exerted upon the finger-piece 2a to move the slide 20 in a direction away from the fenestra and to gradually withdraw the snare-wire 1.9 into the tubular member whereby the loop 21 is gradually reduced in size; this is continued until the loop 21 has been so adjusted as to strangle the tonsil. As soon as the loop has been adjusted to bring about this result the trigger is pivotally pressed rearwardly by another linger of the same hand. to the position shown in Fig. 3 and by a pressure upon the surface 26, forces the teeth 29 of the pawl 26 into engagement with the screw-threads of the screw 30 and thereby locks the slide upon the member 10 so as to maintain the snare loop in its adjusted position. At such time as it is desirable to excise or complete the separation of the tonsil the handle 33 is retated and thus brings about a rotation of the adjusting screw 30. Because of the engagement of the pawl 26 with said screw 30 this operation causes the slide 20 to move rearwardly upon the surface 13 to a further extent which causes a further reduction in the size of the snare-loop 21 and finally causes the snare-wire to completely excise the tonsil. This adjustment of the parts through the medium of the screw 30 is continued until the one member of the fork of the trigger 25 engages the trip 37 whereupon said trigger is shifted back to the position shown in Fig. 1 in which the pawl 26 automatically releases itself from the screw because of the inherent resiliency of the member 27. The slide 20 may thereupon be returned to its forward position in a comfortable manner exerting a pressure upon lessees the thumb-piece 34 whereby the snare-loop 2-1 is again extended into the groove 18 of the fenestra 17. During these operations the grip 35 is securely held in the one hand of the physician and serves to place said in strument under complete and easy control while at the same time two of the fingers of thehand are left free to manipulate the finger-piece 34: and the trigger 25 with -i minimum of effort upon the part of "he physician. Because of the fact that the grip 35 extends in a direction at right angles to the plane of the fenestra 1? all parts of the instrument when the latter is in use, occupy such positions as to enable the phy cian to utilize said instrument in a most cflicient manner with a minimum of attenti'm to correctly position the same; the physician is thus left free to give his entire attention to the tonsils which are to be excised. Be cause of the absence of serrations or teeth upon the guide surface 13 it is possible to adjust the slide to the minutest degree desirable, such adjustment in no sense depen l ing upon the engagement of serrations or teeth with some element of the slide; in addition, the absence of such serrations on the guide surface brings about a more even and uniform sliding movement of the slide and reduces vibration in the instrument and thereby increases the control thereof by the physician. The detachability of the grip 35 is desirable in that it enables the instrument to be packed into a relatively small compass. The arrangement of the pawl 26 upon a resilient member 2'? enables this unit to be renamed from the instrument when this is desirable for cleaning or other purposes: at the same time the arrangement shown and described makes the operation of the pawl a most positive one and reduces the effort necessary to actuate the same to a minimum. To release the pawl it is simply necessary to give the trigger 25 a slight movement toward the fenestra 17, the movement itself being completed by the camming action of the surface 26 upon said trigger under the influence of the resilient member 27.

Various changes in the specilic form shown and. described may be made within the scope of the claims without departing from the spirit of my invention.

I claim 1. A tonsillotome comprising a carrier terminating at one end in a fcucstra and having a smooth guide surface, a snare wire movable relatively to the fenestra. a slide connected with said wire and slidable on said guide surface, a finger-piece connected with said slide and extending downwardly. therefrom for slidably actuating the same to operate said snare-wire. a trigger pivotally connected with said slide and located rearwardly of said fingenpiece in contiguous relation thereto, means operated by a rearward movement of said trigger for locking said slide in an adjusted position, mechanism for shifting said slide from said adjusted position when said means isin locked position and a grip connected with said carrier and extending therefrom in a a direction at right angles to the plane of said fenestra.

2. A tonsillotoine comprising a carrier terminating at one end in a fenestra and having a smooth guide surface, a snare-wire movable relatively to the fenestra, a slide connected with said wire and slidable on said guide surface, a finger-piece connected with said slide and extending downwardly therefrom for slidably actuating the same to operate said snare-wire, a trigger pivotally connected with said slide and located rearwardly of said finger-piece in contiguous relation thereto, a rotatable adjusting screw, a resilient pawl controlled by said trigger and arranged to be adjusted by a rearward movement thereof into engage ment with said adjusting screw, means for rotating said screw to shift said slide from said adjusted position and a grip connected with said carrier and extending therefrom in a direction at right angles to the plane of sald fenestra.

3. A tonsillotome comprising a main member having a smooth guide surface, a tubular member projecting forwardly from said main member and terminating in a fenestra, a snare-wire in said tubular member and adjustable relatively to said fenestrain the form of a gradually decreasing loop, a slide connected with said snare-wire and slidable on said guide surface, a fingerpiece connected with the slide for slidably actuating the same to operate said snarewire, an adjusting screw rotatably mounted in said main member, a toothed pawl mounted on said slide, a trigger pivotally connected with said slide and located rearwardly of said finger-piece for throwing said pawl into engagement with said screw whereby said slide and snare wire are located in an adjusted position, a device for rotating said screw to slidably shift said slide from its adjusted position, a thumb-piece on said slide for moving it forwardly on said guide surface and a hand grip detachably connected with said main member and extending therefrom in a direction at right angles to the plane of said fenestra.

In testimony whereof I have hereunto set my hand.

ABRAHAM J. SHEKTER. 

